The funny thing about for-profit companies is that their stakeholders expect them to make—are you ready for it—a profit. And for the majority of industries around the globe, people universally accept this fact.

It is interesting, therefore, to look at the healthcare industry where the existence of a for-profit model is less widely accepted or at least is tinged with outcries for profit but not profiteer­ing. Because health is very personal, the discus­sion of profit in this sector has become rancor­ous. So rancorous, in fact, that the industry has been forced to respond, whether because of personal reflections from within or social and governmental pressures from without.

At last month's Society for Biomolecular Sciences meeting, Dr. Ted Sybertz, SVP of Scientific Affairs at Genzyme, distilled the new reality in which the pharmaceutical industry finds itself. Before a crowd of scientists and business people, he said that if the industry expects people to continue to support its efforts, it needs to plan to give something back to the community. In that simple statement, Sybertz encapsulated the reason why pharmaceutical and biotechnology companies are going to find themselves increasingly pressured to partici­pate in the three Ps of global healthcare—pri­vate-public partnerships (PPPs).

In its simplest form, PPP can take the form of a for-profit company offering a non-profit or charitable organization access to derelict or under-utilized IP—perhaps a compound that the larger company is no longer pursuing or that the smaller organization will use for a novel—typically low-end—purpose. In other cases, the PPP interaction may involve more active participation on everyone's part.

Sybertz spoke of Genzyme's Humanitarian Assistance to Neglected Diseases (HAND) ini­tiative, explaining that the company's goal was to share resources and costs with its partners in areas in which it had particular expertise but no commercial interests. He was also quick to point out, however, that Genzyme was not interested in becoming a CRO or funding agency for its partners. It had no plans to be involved in clinical development and would be unlikely to manufacture any drugs that arose from a PPP.

At the same time, the roles played by partners are not always so clear cut and really depend on context. I recently spoke with Dr. Victoria Hale, CEO of the Institute for OneWorld Health (IOWH), a non-profit corporation specializing in neglected diseases, about her group's work with BioFocus DPI and others on the search for a therapeutic to treat secretory diarrhea, a disease that kills millions children each year (see story).

"There are many reasons to define PPP dif­ferently and those definitions will change over time according to who your partners are and who plays a dominant role," she explained.

Hale also spoke at length about a recent PPP in which IOWH participated that led to the resuscitation of paromomycin, an anti-infective that had been discontinued—for the treatment of visceral leishmaniasis or kala-azar, the sec­ond most deadly parasitic disease after malaria. In this case, IOWH was the leading partner in a PPP that involved the WHO, India's Gland Pharma and Amsterdam's IDA Solutions, as well as four clinical sites in India.

"This partnership is an innovative way for our company to use its expertise and corpo­rate philanthropy to benefit India," said Dr. Ravi Penmetsa, Gland managing director, in the announcement. "With our combined resources, we are confident that we will…save the lives of thousands of people afflicted with kala-azar."

"I believe that the medical community is ready to open its eyes and see what global health means and to understand that with so many advances and extremely elegant technologies that we have in the West, that we really need to begin to share these technologies, to go after these diseases that have been around for hun­dreds and hundreds of years," Hale told me. "We can't be so technologically advanced and still have these diseases that have been killing millions of people for five hundred years. There is now a critical mass among the clinical, sci­entific and technological communities, among funders, and we're going to do something about this."

As Hale says, the world has adopted a new outlook on the well being of its citizenry and whether it wants to or not, the pharmaceutical industry is going to have to adjust—and seems to be—to that new reality; PPPs being just one mechanism.